Chiltern CCG Southern Locality Profile...Centre, Southmead Surgery, The Misbourne Practice, Denham...

Chiltern CCG – GP LOCALITY PROFILES – Southern

1 Produced by Buckinghamshire Public Health ([email protected]), November 2016

Chiltern CCG

Southern Locality Profile



Overview Health is influenced by a wide range of factors including the circumstances in which people are born, grow up, live and work. The specific health needs of an area are also influenced by the population’s age and ethnic mix, as different ethnic groups have different health needs. This locality profile includes data on the key influences of health and wellbeing, such as levels of deprivation, health related behaviours (such as smoking and physical activity), health outcomes, and use of health care services, in addition to the demographic profile of the population. This profile should be read together with the Joint Strategic Needs Assessment 2016-20. The report is available at www.healthandwellbeingbucks.org/what-is-the-JSNA. This profile was produced by Buckinghamshire Public Health, Buckinghamshire County Council in November 2016 (email: [email protected]). Understanding localities The Practices in Buckinghamshire recognised that they each have a unique patient population with different needs, some of which may depend on where they live in the county. With this in mind, seven different geographical areas, called localities, were identified to focus their work on a very local level. The GP practices in each of the locality areas work together to discuss and agree what is best for their patients, meeting on a regular basis to discuss progress on their priorities for healthcare in their area of the county. Localities are a health-based geography (meaning that they are based on the location of Practice populations) which, in Buckinghamshire, are different to the administrative county boundary. Due to the non-coterminous nature of health and county, some locality-level analyses may not contain complete data, and will be highlighted. Setting Buckinghamshire in the national context Buckinghamshire is the 5th least deprived upper-tier local authority in England. The county has some of the best educational and social outcomes and consequently health outcomes in the country, as reported through the Public Health Outcomes Framework published by Public Health England. Buckinghamshire therefore has relatively low healthcare funding as a consequence of the above. Although residents overall are much healthier than the national average, there is significant variation in the health and wellbeing across the county. Deprivation within Buckinghamshire The following maps show the latest data (Indices of Deprivation 2015) for the Index of Multiple Deprivation (map 1), Income Deprivation Affecting Children, which is the proportion of children aged 0-15 living in an income deprived family in receipt of benefits (map 2) and Income Deprivation Affecting Older People, which is the proportion of all those

http://www.healthandwellbeingbucks.org/what-is-the-JSNA

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aged 60 or over who experience income deprivation (map 3), each distributed in to equal fifths of the population (deprivation quintiles). Map 4 shows the proportion of the working age population, in each ward, claiming Job Seekers Allowance (JSA, July 2016).



Map 1 Map 2



Map 3 Map 4



Map of Chiltern CCG practices



Key Practice Name Locality

1 K82001: Rectory Meadow Surgery Amersham and Chesham

2 K82004: Amersham Health Centre Amersham and Chesham

3 K82024: The New Surgery Amersham and Chesham

4 K82035: John Hampden Surgery Amersham and Chesham

5 K82037: Water Meadow Surgery Amersham and Chesham

6 K82049: Hughenden Valley Surgery Amersham and Chesham

7 K82058: Gladstone Surgery Amersham and Chesham

8 K82618: Prospect House Amersham and Chesham

9 K82621: Little Chalfont Surgery Amersham and Chesham

10 K82010: Tower House Surgery Wycombe

11 K82017: Desborough Surgery Wycombe

12 K82020: Chiltern House Medical Centre Wycombe

13 K82022: Kingswood Surgery Wycombe

14 K82030: Wye Valley Surgery Wycombe

15 K82036: Riverside Surgery Wycombe

16 K82044: Carrington House Surgery Wycombe

17 K82053: Priory Surgery Wycombe

18 K82603: Cressex Health Centre Wycombe

19 K82006: The Ivers Southern

20 K82008: The Hall Practice Southern

21 K82031: Threeways Surgery Southern

22 K82033: Burnham Health Centre Southern

23 K82045: Southmead Surgery Southern

24 K82051: The Misbourne Practice Southern

25 K82055: Denham Medical Centre Southern

26 K82078: The Allan Practice Southern

27 K82005: Hawthornden Surgery Wooburn Green

28 K82011: Millbarn Medical Centre Wooburn Green

29 K82012: Highfield Surgery Wooburn Green

30 K82023: The Marlow Medical Group Wooburn Green

31 K82029: Cherrymead Surgery Wooburn Green

32 K82046: The Simpson Centre Wooburn Green

33 K82048: Stokenchurch Medical Centre Wooburn Green

34 K82066: Pound House Surgery Wooburn Green



Specific issues to consider from data available for Chiltern CCG’s Southern Locality

The Southern locality’s population size is 84,033 people – around 15% of the total Buckinghamshire population.

The age profile is very similar to that of Chiltern CCG and the Buckinghamshire localities average. 20% of the population is aged 65+, 9.5% is aged 75+ and 3% is aged 85+, which is similar to the Chiltern CCG averages of 18.2%, 8.5% and 2.6% respectively and the Buckinghamshire averages of 17.9%, 8.2% and 2.4% respectively.

The locality is less deprived compared to Chiltern CCG and Buckinghamshire as a whole, but areas in Burnham Church, Burnham Lent Rise, Iver Heath, Iver Village and Richings Park, Stoke Poges, Wexham and Iver West wards are in the most deprived population quintile in Buckinghamshire

The locality is less ethnically diverse compared to Chiltern CCG and Buckinghamshire as a whole.

There is a difference of 3 years in life expectancy between males and females in Southern locality, which is the same as in Buckinghamshire localities combined.

The population of Southern locality experiences a mixed picture for health, performing better on some indicators and worse on others, and has similar life expectancy, compared to the Buckinghamshire population. Emergency admission rates to hospital are similar to the Buckinghamshire and Chiltern CCG average. Early death rates are similar to Buckinghamshire, which itself has some of the lowest death rates in the country.



DETAILED REPORT Demography - Population

Locality size (2016): There are 8 GP practices in the Southern locality with a total registered population of 84,033, which is 25% of the total Chiltern CCG registered population.

GP Practices (2016): The Ivers, The Hall Practice, Threeways Surgery, Burnham Health Centre, Southmead Surgery, The Misbourne Practice, Denham Medical Centre and The Allan Practice.

Age profile: Similar to Buckinghamshire and Chiltern CCG average with around 23% aged 0-19 and 1 in 4 (25.3%) aged 60 and over. There is a slightly lower proportion of those aged 0-9 compared to Chiltern CCG average in both males and females (11.4% v 12.3%).

Population changes: There has been an increase in all the older population groups since 2014 with a rise of 6.4% in those aged 65 and over, 7.5% aged 65-74, 2.8% aged 75-84 and 10.8% increase in those aged 85-94. There has been an 11.2% in those aged 85 and over, and a 14.6% increase in those aged 95 and over although this involves smaller actual numbers (29).

Population Projection 2016-2026: The population for South Bucks District is predicted to increase by 9% (6,600 people). The district population is forecast to rise by 12% (2010 people) in those aged 0-19 (compared to a rise of an average of 10% in Buckinghamshire); a fall of 6% (580 people) in those aged 20-34 (compared to a fall of an average of 1% in Buckinghamshire); and 24% increase (3,510 people) in those aged 65 and over (which is the same as the average increase in Buckinghamshire). This includes a 46% increase (1,100 people) in those aged 85 and over (compared to an average increase of 47% in Buckinghamshire).

Ethnicity (2011): People from a black and minority ethnic group account for 14.6% of

the total population compared to Chiltern CCG average of 15.9%, Buckinghamshire average of 13.6% and England average of 14.7% [Census 2011].

Deprivation (2015): The Index of Multiple Deprivation (2015) based on LSOAs shows an average deprivation score of 8.5 in Southern locality compared to 9.1 in Chiltern CCG (Range 6.4-13.4). (Higher the score, more the deprivation).



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Southern Locality registered population pyramid, July 2016

FemaleSouthern Locality

MaleSouthern Locality

FemaleCCCG

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FemaleEngland

MaleEngland

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South Bucks DC registered populationJuly 2016 with 2026 projection

FemaleSouth Bucks 2016

MaleSouth Bucks 2016

FemaleSouth Bucks 2026

MaleSouth Bucks 2026

Female Bucks 2026 Male Bucks 2026



Housing in Poor Condition: This indicator from the Census 2011 indicates when a household has at least one bedroom too few for the number and composition of people living in the household and is considered overcrowded by the bedroom standard. In Southern locality, 2.4% of the population are living in households which are considered as overcrowded by this indicator which is below the average for Chiltern CCG of 3.7%.

Births, low birth weight and infant mortality

Births: There were 784 live births in the Southern locality, compared to 6,089 in all Buckinghamshire localities in 2015 (12.9% of all births in Buckinghamshire CCGs). The birth rate in the Southern locality was statistically significantly lower at 10.2, compared to the Buckinghamshire CCG rate of 11.8 in 2015, and the England rate of 12.2 (live births per 1,000 population, in 2014). The general fertility rate (per 1,000 female population aged 15-44) in the locality was 61.7 (which is not statistically different) compared to 64.8 in all Buckinghamshire localities, and 62.2 in England (2014).

Low birth weight (LBW): 2013-15 records (from ONS) show that 6.8% of babies born to mothers in the Southern locality had a low birth weight (<2,500g), compared to 7.4% of babies in all Buckinghamshire localities (and 7.4% of babies in England in 2014, latest data). This is not statistically different to the combined Buckinghamshire localities data.

Infant deaths: The infant mortality (deaths at ages under 1 year) rate for Southern

locality in 2013-15 was 2.2, which is lower (but not statistically different) than the

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combined Buckinghamshire localities rate of 3.8 (England rate, in 2014, was 4.0 per 1,000 live births).

Children

Early Years Foundation Stage Profile (EYFSP): In the Southern locality, 71.1% of pupils attending Buckinghamshire maintained schools and academies, achieved a Good Level of Development in 2016. This is higher than the average of 70.5% for all pupils attending Buckinghamshire schools/settings.

Looked After Children: The rate of Looked After Children in Southern locality is 1.4 per 1,000 which is statistically significantly lower than the combined Buckinghamshire localities rate of 3.3 (as at 31st March 2016).

Life Expectancy and Mortality

Life expectancy: The male life expectancy in the Southern locality population in 2013-15

was 81.6 years, which is not statistically different to the Bucks average of 82.3 years (England average = 79.5 in 2012-14). Female life expectancy was 84.7 in Southern locality compared to 85.1 in Bucks, which is not statistically different (England average = 83.2 in 2012-14).

Mortality in under 75s: The chart below shows the contribution of each condition to the ‘gap’ in mortality between the locality and the Buckinghamshire mortality rate. The mortality profile in the under 75 population in Southern locality shows no statistical difference to the overall premature death rate than the combined Buckinghamshire localities (266.0 vs 240.6 per 100,000), with the major causes of premature deaths being Cancer, Circulatory disease and Respiratory disease.



Mortality in over 75s: The mortality profile in the over 75 population in Southern locality also shows no statistical difference to the overall death rate than the combined Buckinghamshire localities (6,850 vs 6,577 per 100,000), with the major causes of deaths in older ages being Circulatory disease, Cancer and Respiratory disease.

Southern Locality Bucks CCGs

Other causes 10.9 11.3

Infectious & parasitic diseases 2.3 2.4

External causes 15.9 15.9

Genitourinary system diseases 0.0 1.4

Nervous system diseases 20.0 10.6

Mental and behavioral disorders 6.0 4.3

Digestive diseases 12.7 13.4

Respiratory diseases 22.1 18.8

Cancers 122.1 112.4

Circulatory diseases 55.6 50.2

55.6 50.2

122.1112.4

22.1

18.8

12.7

13.4

20.0

10.6

15.9

15.9

10.9

11.3

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Under 75s, cause specific mortality profile (2013-15 combined)Southern Locality

Other causes

Infectious & parasitic diseases

External causes

Genitourinary system diseases

Nervous system diseases

Mental and behavioral disorders

Digestive diseases

Respiratory diseases

Cancers

Circulatory diseases

Southern Locality Bucks CCGs

Other causes 370.2 307.6

Infectious & parasitic diseases 51.5 72.9

External causes 181.5 171.6

Genitourinary system diseases 178.0 159.6

Nervous system diseases 490.0 419.7

Mental and behavioral disorders 858.0 861.9

Digestive diseases 191.2 272.9

Respiratory diseases 1,234.6 1080.2

Cancers 1,583.6 1481.4

Circulatory diseases 1,908.8 1884.5

1,908.8 1884.5

1,583.6 1481.4

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Over 75s, cause specific mortality profile (2013-15 combined)Southern Locality

Other causes

Infectious & parasitic diseases

External causes

Genitourinary system diseases

Nervous system diseases

Mental and behavioral disorders

Digestive diseases

Respiratory diseases

Cancers

Circulatory diseases



Lifestyle

Smoking: Based on the Annual Population Survey (APS), 11.0% of adults are estimated

to be smokers in Buckinghamshire compared to 16.9% in England (2015). This equates to around 7,371 current smokers in Southern locality.

Physical Activity: Based on the Active People Survey (APS) from Sport England, 22.0% of adults in Buckinghamshire are estimated to be physically inactive (less than 30 minutes activity a week), which is better than the England figure of 28.7%. This equates to around 15,140 adults in Southern locality.

Excess weight in Adults (Obese and overweight): Based on the Active People Survey (APS) from Sport England, 63% of adults in Buckinghamshire are estimated to be obese or overweight, which is similar to the England figure of 65%. This equates to around 43,012 adults in Southern locality.

Alcohol consumption: Based on the 2011 Topography of Drinking Behaviours in England, 7.6% of drinkers in Buckinghamshire are estimated to be higher risk (harmful) drinkers (men who regularly drink over 8 units per day or over 50 units per week and women who regularly drink over 6 units per day and over 35 units per week), compared to 7.1% in England. This equates to around 5,198 in Southern locality.

Obesity (Children) o Aged 4-5 years: According to the National Child Measurement Programme

(NCMP), in 2014-15, 16.5% of children aged 4-5 years (Reception Year) are estimated to be overweight or obese in the Southern locality, compared to 18.6% in Buckinghamshire localities (which is not statistically significantly different), and 21.9% in England.

o Aged 10-11 years: According to the National Child Measurement Programme

(NCMP), in 2014-15, 25.1% of children aged 10-11 years (Year 6) are estimated to be overweight or obese in the Southern locality, compared to 26.6% in Buckinghamshire localities (which is not statistically significantly different), and 33.2% in England.

In treatment for substance misuse o The rate of adult clients in significant contact with Buckinghamshire’s substance

misuse treatment system (structured and non-structured) during 2013/14 to 2015/16 was 159.1 (per 100,000) in the Southern locality, which is statistically significantly lower than in Buckinghamshire localities (combined rate of 274.2).

o The rate of adult clients in significant contact with Buckinghamshire’s substance misuse treatment system for alcohol only use (structured and non-structured) during 2013/14 to 2015/16 was 62.3 (per 100,000) in the Southern locality, which is significantly statistically lower than in Buckinghamshire localities (combined rate of 109.6).

o The rate of adult clients in significant contact with Buckinghamshire’s substance misuse treatment system for drug use (structured and non-structured) during 2013/14 to 2015/16 was 96.8 (per 100,000) in the Southern locality, which is



statistically significantly lower than in Buckinghamshire localities (combined rate of 164.6).

Screening, immunisation and NHS Health Checks

Cancer screening: o Cervical Cancer: 75.9% of eligible women were screened for cervical cancer in

Southern locality compared to 75% in Chiltern CCG (NHS Cancer Screening Programme 2014/15).

o Breast Cancer: 74.9% of eligible women were screened for breast cancer within 6 months of invitation in Southern locality compared to 76.2% in Chiltern CCG (NHS Cancer Screening Programme 2014/15).

o Bowel Cancer: 56.2% of eligible people were screened for bowel cancer within 6 months of invitation in Southern locality compared to 58% in Chiltern CCG (NHS Cancer Screening Programme 2014/15).

Flu vaccination: In 2015/16, 69% of population aged 65 and over in Southern locality received the influenza vaccination compared to the Buckinghamshire average of 71%; slightly lower than the recommended level of uptake at 75%. Uptake among the pregnant group was 43% in Southern locality, the same as the Buckinghamshire average. Uptake among children aged 2, 3 and 4 was 39%, and among children aged 5 and 6 was 44%, both the same as the Buckinghamshire averages.

NHS Health Checks: In 2015/16, local data shows 6.7% of the eligible population in Southern locality received an NHS Health Check compared to the Chiltern CCG average of 7.6% and Buckinghamshire average of 7.2%

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% Offered and Given Health Check, by CCG locality in 2015/16

% Offered Health Check

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Equivalent to 50% of eligible population given a health check



Long term conditions – Detection and management

The General Practice disease registers provide a count of individuals on registers such as Coronary Heart Disease (CHD), Hypertension, Chronic Obstructive Pulmonary Disease (COPD) register. These are detected prevalence rates and may not be true prevalence rates. Nationally, Public Health England have also developed models to estimate the prevalence of long term conditions in the local population using models that help estimate prevalence of conditions such as diabetes, hypertension, COPD, Dementia and CHD. These estimates help local healthcare organisations understand the undetected prevalence and actual disease burden. Modelled prevalence estimates draw on national surveys and local relevant data such as age, sex and deprivation. These modelled estimates are then compared against GP recorded data to identify the proportion of cases that may as yet be undiagnosed. It is important to note that these estimates have limitations but can be used to understand the ratio of detected to estimated prevalence of conditions like diabetes or hypertension. Confidence intervals are usually too wide to statistically compare the estimates locally and have not been published.

Expected prevalence:

o Hypertension: Hypertension prevalence model estimates that the prevalence of hypertension in Southern locality is around 25% compared to the detected prevalence of 13.7% which means there could be around 9,800 individuals with undiagnosed hypertension in the locality and 36,600 undiagnosed in Chiltern CCG.

o Diabetes: The diabetes prevalence model developed by Public Health England estimates the prevalence of diabetes in Chiltern CCG as 8% compared to the detected prevalence of 5.9%; which means there could be around 6,000 individuals with undetected diabetes in Chiltern CCG with around 1,600 undiagnosed in the Southern locality.

(Note, these are modelled estimates and further analysis using practice population can be done to get approximate number of undetected cases in the practice population).

The NHS Health Checks programme in Buckinghamshire is expected to identify undiagnosed cases of hypertension and diabetes among those aged 40-75.

Dementia: The Dementia modelled prevalence (Primary Care Web Tool, March 2015

data) shows a dementia diagnosis gap in Southern locality, with an estimated prevalence of 1.50% compared to a detected prevalence of 0.86%, which means there could be around 67 undiagnosed dementia cases in the locality. This compares to an estimated prevalence rate of 1.30% vs. 0.65% detected in Chiltern CCG (2,152 people), and 1.24% vs. 0.68% in Bucks CCGs combined (3,195) people.

Detected prevalence: (Source: 2015/16 CQRS provisional figures. Since these figures are not published by HSCIC, regional and national comparator values are not yet available.)



o Hypertension: 13.7% in Southern locality with 11,474 individuals on hypertension register, compared to 13.4% in Buckinghamshire CCGs (combined).

o Diabetes: 5.7% in Southern locality with 3,850 individuals on the diabetes register, compared to 5.9% in Buckinghamshire CCGs (combined).

o Coronary heart disease (CHD): 3.0% in Southern locality with 2,544 individuals on the CHD register similar to Buckinghamshire CCGs (combined) average of 2.9%.

o Heart failure (HF): 0.59% in Southern locality with 497 individuals on the HF register, compared to 0.60% in Buckinghamshire CCGs (combined).

o Stroke and Transient Ischaemic Attack (STIA): 1.84% in Southern locality with 1,540 individuals on the STIA register, compared to 1.62% in Buckinghamshire CCGs (combined).

o Atrial Fibrillation (AF): 2.1% in Southern locality with 1,740 individuals on the AF register, compared to 1.9% in Buckinghamshire CCGs (combined).

o Chronic Kidney Disease (CKD): 2.9% in Southern locality with 1,902 individuals on the CKD register, compared to 3.3% in Buckinghamshire CCGs (combined).

o COPD: 1.30% in Southern locality with 1,091 individuals on the COPD register, compared to Buckinghamshire CCGs (combined) average of 1.36%.

o Asthma: 5.5% in Southern locality with 4,582 individuals on the Asthma register, compared to 6.0% in Buckinghamshire CCGs (combined).

o Depression: 7.7% in Southern locality with 5,119 individuals on the Depression register, compared to 7.9% in Buckinghamshire CCGs (combined).

o Dementia: 0.86% in Southern locality with 720 individuals on the Dementia register, compared to 0.73% in Buckinghamshire CCGs (combined).

o Severe mental illness (SMI): 0.61% in Southern locality with 507 individuals on the SMI register, compared to 0.72% in Buckinghamshire CCGs (combined).

o Cancer: 2.9% in Southern locality with 2,464 individuals on the Cancer register, compared to 2.7% in Buckinghamshire CCGs (combined).

Adult Social Care

Trend summary for clients receiving Adult Social Care services 2013/14 to 2015/16 (age-standardised per 100,000 population aged 18+)



For definitions of these terms please see the glossary on page 22

The increase in Direct Payments promotes choice and control for ASC service users. The provision of Equipment has decreased, whilst the provision of Telecare and Assistive Technology has increased which enables people to live in their own homes for longer. The decrease in Home Care displayed in 2015/16 reflects recommissioning of the service at year end and review of all recorded Home Care packages.

Healthcare use (hospitals) – Secondary Uses Services

Emergency admission rates (Directly standardised rate per 100,000 population, 2015/16. Note: actual admission rates available in summary table)

o All causes: The rate is lower than the combined Buckinghamshire localities but with no significant difference.

Between 2008/09 and 2015/16 the rate of admissions in Southern locality have increased by 19%



o All causes, 65+: The rate is significantly higher than the combined Buckinghamshire localities average.

o All causes, 75+: The rate is significantly higher than the combined Buckinghamshire localities average.

Between 2008/09 and 2015/16 the rate of admissions in Southern locality have increased by 24%

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All Emergency Admissions (excluding admissions to MH Trusts), All Ages, FY 08/09 to FY 15/16, by locality within Chiltern CCG

Amersham & Chesham Southern Wooburn Green Wycombe

Bucks CCGs (Combined) Aylesbury Vale CCG Chiltern CCG



o All circulatory: The rate is significantly higher than the combined Buckinghamshire localities average.

o Coronary Heart Disease (CHD): The rate is lower than the combined Buckinghamshire localities but with no significant difference.

o Stroke: The rate is lower than the combined Buckinghamshire localities but with no significant difference.

o HF: The rate is significantly higher than the combined Buckinghamshire localities average.

o Diabetes: The rate is lower than the combined Buckinghamshire localities but with no significant difference.

o All respiratory: The rate is higher than the combined Buckinghamshire localities but with no significant difference.

o COPD: The rate is lower than the combined Buckinghamshire localities but with no significant difference.

o All cancers: The rate is significantly higher than the combined Buckinghamshire localities average.

o Falls (65+): The rate is significantly higher than the combined Buckinghamshire localities average.

Admission rates for Mental Health (specialties or diagnosis): The rate is significantly lower than the combined Buckinghamshire localities average.

Emergency admissions as a % of patients on the respective disease register (2015/16) o Heart failure: 30% in Southern locality compared to 19% in Buckinghamshire

CCGs (from SCWCSU Urgent Care Dashboard).

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All Emergency Admissions (excluding admissions to MH Trusts), Ages 75+, FY 08/09 to FY 15/16, by locality within Chiltern CCG





o COPD: 11% in Southern locality compared to 11% in Buckinghamshire CCGs (from SCWCSU Urgent Care Dashboard).

Top causes of admissions (all) in people aged 65 and over, 2013/14-2015/16 (combined)

Bed days, 2015/16 o Emergency admission: In 2015/16 the registered population of Southern locality

had a total of 19,121 bed days for emergency admissions. 70.0%, or 13,393 bed days, were in the 65+ population and 54.9%, or 10,503 bed days, were in the 75+ population.

o All admissions: In 2015/16 the registered population of Southern locality had a

total of 33,951 bed days for all admissions. 53.6%, or 18,214 bed days, were in the 65+ population and 40.5%, or 13,752 bed days, were in the 75+ population.

o Emergency admissions 65+: 56.3% of in-year bed days, for the registered

population of Southern locality, are for emergency admissions, with 73.5% of in-year bed days for the population aged 65+ being for emergency admissions.

Repeat admissions, 2015/16 o All ages: In the Southern locality, there were 7,526 emergency admissions to

5,361 people; 3,957 people had a single admission, 868 people had two admissions, 295 people had three admissions and 241 people had four or more emergency admissions in the year. In Southern locality the maximum number of repeat admissions was 25 within the year. Across the Buckinghamshire localities, of the 33,267 people admitted as an emergency in 2015/16, 2,743 were previously admitted as an emergency in 2014/15 and 1,657 of them were also previously admitted as an emergency in 2013/14.

Southern 9237

1 Chronic kidney disease, stage 5 2441 26.4%

2 Cancer 1973 21.4%

3 Cataract 1068 11.6%

4 Pneumonia 881 9.5%

5 Urinary tract infection 589 6.4%

6 Atrial fibrillation and flutter 406 4.4%

7Diverticular disease of large intestine

without perforation or abscess373 4.0%

8 Syncope and collapse 291 3.2%

9 Coronary heart disease 258 2.8%

10 Congestive heart failure 253 2.7%

11 Osteoartritis lower limb 252 2.7%

12 Chest pain, unspecified 235 2.5%

13 Blood in urine 217 2.3%



o Ages 65+: In the Southern locality, there were 3,710 emergency admissions to 2,437 people; 1,640 people had a single admission, 479 people had two admissions, 178 people had three admissions and 140 people had four or more emergency admissions in the year. In Southern locality the maximum number of repeat admissions was 25 within the year. Across the Buckinghamshire localities, of the 12,891 people age 65 and over admitted as an emergency in 2015/16, 1,492 were previously admitted as an emergency in 2014/15 and 925 of them were also previously admitted as an emergency in 2013/14.

o Ages 75+: In the Southern locality, there were 2,678 emergency admissions to 1,736 people; 1,144 people had a single admission, 366 people had two admissions, 123 people had three admissions and 103 people had four or more emergency admissions in the year. In Southern locality the maximum number of repeat admissions was 15 within the year. Across the Buckinghamshire localities, of the 9,045 people age 75 and over admitted as an emergency in 2015/16, 1,128 were previously admitted as an emergency in 2014/15 and 652 of them were also previously admitted as an emergency in 2013/14.

Diabetes repeat admissions o Person admissions: The 45 emergency admissions for diabetes in 2015/16 were

to 39 different people o Repeat admissions: In the Southern locality, 34 people had one admission and 4

people had two admissions and 1 person had three emergency admissions for diabetes. Across the Buckinghamshire localities, of the 222 people admitted as an emergency in 2015/16, 11 were previously admitted as an emergency in 2014/15 and nine of them were also previously admitted as an emergency in 2013/14 for diabetes.

Cancer admissions o All admissions: In 2015/16 in Southern locality, there were 2,944 admissions for

cancer (primary diagnosis). The rate is significantly higher than the combined Buckinghamshire localities average.

o Emergency: Of these, 23.7% (698 admissions) were an emergency. This is lower than the Buckinghamshire average of 26.2%.

Childrens admissions (Directly standardised rate per 100000 population, 2015/16) o All emergency admissions, under 5s: The rate is significantly lower than the

combined Buckinghamshire localities. Between 2008/09 and 2015/16 the rate of admissions in Southern

locality has increased by 19%.



o All emergency admissions, under 15s: The rate is significantly lower than the combined Buckinghamshire localities average.

o All emergency admissions, under 20s: The rate is significantly lower than the combined Buckinghamshire localities average.

o Respiratory admissions (Lower Respiratory Tract Infections), under 20s: The rate is significantly lower than the combined Buckinghamshire localities average.

o Accidental and deliberate injuries, under 15s: The rate is lower than the combined Buckinghamshire localities, but with no significant difference.

o Accidental and deliberate injuries, 15-24s: The rate is significantly lower than the combined Buckinghamshire localities average.

Between 2008/09 and 2015/16 the rate of admissions in Southern locality has decreased by almost 30%.

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All Emergency Admissions, Under 5sFY 08/09 to FY 15/16, by locality within Chiltern CCG





Patient experience – GP

The graph below presents the percentage patient satisfaction score by practice in Chiltern CCG.

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Emergency Admissions for unintentional and deliberate injuries, ages 15-24FY 08/09 to FY 15/16, by locality within Chiltern CCG



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85.0%

90.0%

95.0%

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Chiltern CCG Practices

Patient Satisfaction Score for Chiltern CCG Practices, Published July 2016CCCG average = 86.0% Bucks CCGs average = 85.5% England average = 85.2%

% Good % Good Chiltern CCG % Good Bucks CCGs



Notes/caveats

Indicators where data is not complete for Buckinghamshire localities (this will affect the South locality, Aylesbury Vale CCG total and Buckinghamshire CCGs combined total), i.e. data is only available for Buckinghamshire County only, but matched to localities for analysis purposes;

o Deprivation maps (drawn for Buckinghamshire County, with locality boundaries) o Births o Early Years Foundation Stage Profile o Looked After Children o National Childhood Monitoring Programme (NCMP) o Substance Misuse o Adult Social Care

Glossary Adult Social Care terms Daycare: Care and activities that take place outside of the home, usually at a day care centre. These activities tend to include arts, craft and gentle exercise along with a range of other activities. Direct Payment: Direct Payments are a sum of money available to people who have been assessed as eligible for Social Care services. This money provides clients with the choice and control to purchase their own care services. Equipment: Equipment is provided by Buckinghamshire County Council to help with daily living and personal care. This may include small items such as a raised toilet seat and minor home adaptations including stair or bath rails. Home Care: Home care is care provided in the client’s home by trained carers. This service helps with daily activities including getting dressed, supporting basic healthcare needs, meal preparation and toileting. Laundry: The Laundry service includes the collection, transportation, cleaning and delivery of clothes and bed linen. Supported Living: Our Supported Living services enable people with learning disabilities or long-term mental health needs to live in the community, in small and staffed homes. Support is provided to help with budgeting and household expenses. Telecare: Telecare includes assistive technology offering remote care to potentially vulnerable or physically less able people. This service provides care and reassurance to enable people to live independently in their own homes. Other terms Detected prevalence: The number of patients on each disease register, as a percentage of the number of patients on practices' lists.



Directly Age-Standardised Rate (DASR) rate: DASR for an area is the number of events, usually expressed per 100,000, that would occur in that area if it had the same age structure as the standard population (e.g. European population) and the local age-specific rates of the area applied. This is useful for comparing populations with different age structures. Good level of development (GLD): Children are defined as having reached a GLD at the end of the EYFS if they achieve at least the expected level in:

The Early Learning Goals in the prime areas of learning (Communication and Language, Physical Development, Personal, Social and Emotional Development) and;

The Early Learning Goals in the specific areas of Mathematics and Literacy. Statistical Significance: Statistical significance (also mentioned as ‘significant’) means that a difference that is observed is unlikely to be due to chance alone.



Comparison measured against Bucks localities (combined) average

Statistically worse Higher Not compared

Similar Similar

Statistically better Lower

Indicator Year England Bucks AVCCG CCCG Central North South Amersham

& Chesham Southern

Wooburn

Green Wycombe

Total population 2016 549,458 209,871 339,587 103,189 58,328 48,354 75,666 84,033 89,602 90,286

under 5 population 2016 32,338 12,652 19,686 7,522 2,795 2,335 4,135 4,443 5,069 6,039

under 5 % of total 2016 5.8% 5.9% 6.0% 5.8% 7.3% 4.8% 4.8% 5.5% 5.3% 5.7% 6.7%

65+ population 2016 98,445 36,589 61,856 14,928 10,897 10,764 15,131 16,492 17,937 12,296

65+ % of total 2016 17.3% 17.9% 17.4% 18.2% 14.5% 18.7% 22.3% 20.0% 19.6% 20.0% 13.6%

75+ population 2016 44,899 15,945 28,954 6,813 4,398 4,734 7,035 7,944 8,219 5,756

75+ % of total 2016 7.8% 8.2% 7.6% 8.5% 6.6% 7.5% 9.8% 9.3% 9.5% 9.2% 6.4%

85+ population 2016 13,373 4,698 8,675 2,060 1,233 1,405 2,089 2,539 2,478 1,569

85+ % of total 2016 2.3% 2.4% 2.2% 2.6% 2.0% 2.1% 2.9% 2.8% 3.0% 2.8% 1.7%

Black and minority ethnic communities 2011 14.7% 13.6% 9.8% 15.9% 16.1% 4.8% 3.6% 9.0% 14.6% 6.9% 31.0%

Deprivation (average IMD score) 2015 21.8 9.7 10.8 9.1 13.5 8.9 8.0 7.3 8.5 6.4 13.4

Housing in poor condition:

No central heating 2011 2.7% 1.4% 1.6% 1.4% 1.6% 1.7% 1.4% 1.2% 1.1% 1.2% 1.9%

Overcrowding (bedrooms) 2011 4.6% 3.6% 3.5% 3.7% 5.3% 2.0% 1.7% 2.8% 2.4% 2.0% 7.3%

Live births* 2015 6,089 2,404 3,685 1,487 592 325 724 784 801 1,376

Crude birth rate (per 1,000)* 2015 (P) 11.8 12.4 11.5 15.4 10.1 8.3 9.7 10.2 10.1 15.1

General fertility rate (per 1,000)* 2015 (P) 64.8 66.9 63.5 75.1 57.8 55.4 59.5 61.7 61.4 68.3

Low birth weight births, % <2,500g * 2013-15 7.4% 7.6% 7.2% 8.0% 7.0% 6.7% 7.9% 6.8% 6.0% 7.8%

Deaths at ages under 1 year 2013-15 68 30 38

Infant mortality rate (per 1,000) 2013-15 3.8 4.4 3.5 5.5 1.7 4.1 5.0 2.2 1.2 4.7

# EYFSP pupils within the area* 2016 6,582 1,410 692 449 841 710 918 1,266

% achieving a Good Level of Development 2016 70.5 71.0 77.9 77.5 73.6 71.1 72.1 60.5

Looked After Children (LAC) rate (per 1,000) 2015/16 3.3 4.2 2.8 5.6 2.8 2.4 2.8 1.4 2.3 4.2

Life expectancy at birth - PERSONS 2013-15 83.8 82.9 84.3 81.4 84.1 84.7 85.6 83.2 85.3 83.2

Life expectancy at birth - MALES 2013-15 82.3 81.7 82.6 80.2 82.5 83.7 83.5 81.6 83.8 81.7

Life expectancy at birth - FEMALES 2013-15 85.1 84.1 85.9 82.4 85.7 85.6 87.6 84.7 86.6 84.6

All cause premature mortality rate 2013-15 241 254 233 293 236 212 204 266 211 255

All cause 75+ mortality rate 2013-15 6,577 7,323 6,167 8,559 6,502 6,280 5,491 6,850 5,586 6,877

* Data item for which areas in South Oxfordshire cannot be obtained

(P) Provisional data - awaiting updated populations

Chiltern CCG

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Green Wycombe

Excess weight in children, 4-5 years (YrR)* 2014-15 18.6% 19.4% 18.0% 20.2% 18.5% 18.1% 22.4% 16.5% 17.3% 16.2%

Excess weight in children, 10-11 years (Yr6)* 2014-15 26.6% 27.7% 25.9% 30.4% 22.6% 28.6% 27.5% 25.1% 20.1% 29.9%

Adults in substance

misuse treatment rate (per 100,000)*

2013/14 -

2015/16274 296 261 441 180 154 219 159 196 441

Adults in alcohol treatment rate (per 100,000)*2013/14 -

2015/16109.6 126.3 99.1 171.3 88.3 84.5 100.6 62.3 90.0 137.9

Adults in drug treatment rate (per 100,000)*2013/14 -

2015/16164.6 169.7 161.4 269.8 91.3 69.5 118.1 96.8 105.7 303.4

Cervical Cancer Screening 2014/15 73.5 77.3 75.1 74.2 81.0 79.8 77.6 75.9 78.1 69.2

Breast Cancer Screening (within 6mths invite) 2014/15 72.8 74.8 76.2 72.9 71.5 79.8 75.7 74.9 79.6 75.0

Bowel Cancer Screening (within 6mths invite) 2014/15 57.6 59.0 58.0 55.1 60.9 62.6 62.6 56.2 60.3 52.2

Flu vaccination - 65+ population 2015/16 71.0% 70.6% 71.3% 71.2% 69.8% 70.6% 73.9% 69.1% 72.3% 69.3%

Flu vaccination - pregnant women 2015/16 43.0% 44.5% 42.0% 41.9% 49.8% 48.1% 46.7% 43.4% 40.2% 39.4%

Flu vaccination - children aged 2, 3 or 4 2015/16 38.9% 36.5% 40.3% 30.1% 38.4% 53.1% 43.1% 38.5% 49.1% 31.7%

Flu vaccination - children aged 5 or 6 2015/16 44.2% 40.2% 46.7% 32.6% 52.6% 46.5% 55.5% 43.5% 63.8% 26.5%

NHS Health Checks - % Offered 2015/15 16.5% 15.5% 17.2% 14.3% 16.6% 15.6% 18.0% 14.4% 19.4% 17.0%

NHS Health Checks - % Uptake 2015/16 7.2% 6.6% 7.6% 5.6% 7.1% 6.9% 8.1% 6.7% 9.5% 6.1%

Hypertension 2015/16 13.4% 13.5% 13.3% 11.9% 14.3% 15.9% 13.7% 13.7% 14.0% 11.9%

Diabetes 2015/16 5.9% 6.0% 5.9% 6.4% 5.5% 5.8% 5.5% 5.7% 5.1% 7.2%

Coronary Heart Disease (CHD) 2015/16 2.9% 3.1% 2.8% 3.0% 3.0% 3.4% 2.8% 3.0% 2.8% 2.6%

Heart Failure 2015/16 0.60% 0.67% 0.56% 0.59% 0.66% 0.87% 0.54% 0.59% 0.59% 0.52%

Stroke & Transient Ischaemic Attack (TIA) 2015/16 1.62% 1.52% 1.68% 1.42% 1.44% 1.82% 1.69% 1.84% 1.88% 1.31%

Atrial Fibrillation 2015/16 1.9% 1.9% 1.9% 1.6% 2.0% 2.4% 2.1% 2.1% 2.1% 1.3%

Chronic Kidney Disease 2015/16 3.3% 3.1% 3.4% 2.5% 3.1% 4.4% 3.5% 2.9% 3.2% 3.9%

Chronic Obstructive Pulmonary Disease (COPD) 2015/16 1.36% 1.53% 1.25% 1.57% 1.40% 1.59% 1.21% 1.30% 1.34% 1.15%

Asthma 2015/16 6.0% 6.3% 5.9% 6.4% 6.1% 6.2% 6.3% 5.5% 5.8% 6.0%

Depression 2015/16 7.9% 8.7% 7.5% 9.6% 8.4% 7.2% 7.0% 7.7% 7.5% 7.6%

Dementia 2015/16 0.73% 0.77% 0.71% 0.76% 0.72% 0.85% 0.71% 0.86% 0.72% 0.56%

Severe Mental Illness 2015/16 0.72% 0.73% 0.71% 0.95% 0.53% 0.54% 0.68% 0.61% 0.63% 0.90%

Cancer 2015/16 2.7% 2.6% 2.7% 2.2% 2.8% 3.2% 3.1% 2.9% 3.0% 1.8%



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Similar Similar



& Chesham Southern

Wooburn

Green Wycombe

Daycare rate (per 100,000)* 2015/16 131.8 196.0 154.2 78.1 119.3 66.3 105.1 214.0

Direct Payment rate (per 100,000)* 2015/16 333.0 482.4 256.9 247.0 359.2 244.2 261.8 451.1

Equipment rate (per 100,000)* 2015/16 162.7 203.5 163.3 82.1 136.5 154.5 139.4 267.5

Home Care rate (per 100,000)* 2015/16 479.9 644.8 480.1 355.1 486.3 389.0 375.5 640.4

Laundry rate (per 100,000)* 2015/16 44.6 52.3 37.7 39.5 51.4 21.8 36.6 79.3

Supported Living rate (per 100,000)* 2015/16 88.6 153.7 59.8 104.1 72.8 38.6 27.3 156.1

Telecare rate (per 100,000)* 2015/16 1079.4 1587.3 1008.0 870.0 1117.6 896.0 922.9 1157.3

All age emergency admission rate 2015/16 8,762.3 9,113.4 8,551.2 10,079.0 8,215.0 8,295.7 7,637.0 8,649.1 8,065.3 9,741.4

65+ emergency admission rate 2015/16 20,079 20,357 19,902 21,298 19,497 20,009 17,889 22,492 18,481 20,945

75+ emergency admission rate 2015/16 30,760 30,906 30,671 31,052 30,529 31,047 27,673 33,755 29,108 32,355

Emergency circulatory admission rate 2015/16 702.3 712.2 696.0 758.2 707.2 647.7 611.0 789.5 620.9 769.4

Emergency CHD admission rate 2015/16 152.4 172.2 140.9 195.6 166.2 147.4 142.1 136.1 107.8 188.2

Emergency Stroke admission rate 2015/16 118.4 120.9 117.3 146.3 100.0 106.0 96.9 109.8 127.9 134.5

Emergency Heart Failure admission rate 2015/16 99.1 86.1 106.4 86.5 97.6 74.5 66.4 154.4 92.3 110.0

Emergency Diabetes admission rate 2015/16 51.0 60.2 45.8 81.9 41.7 39.9 35.1 50.9 30.5 67.4

Emergency respiratory admission rate 2015/16 1,123 1,166 1,099 1,292 1,170 935 912 1,142 972 1,368

Emergency COPD admission rate 2015/16 147.5 175.0 131.9 222.6 163.9 124.2 95.1 146.3 106.1 190.2

Emergency cancer admission rate 2015/16 702.3 712.2 696.0 758.2 707.2 647.7 611.0 789.5 620.9 769.4

65+ emergency Falls admission rate 2015/16 2,608 2,502 2,668 2,581 2,409 2,497 2,261 3,034 2,650 2,697

Mental Health admission rate 2015/16 195.8 213.2 185.7 278.7 176.8 130.7 157.2 154.7 187.1 235.4

Cancer admission rate 2015/16 2,688 2,548 2,771 2,807 2,410 2,294 2,505 3,463 2,498 2,560

Under 5 emergency admission rate 2015/16 17,660 16,885 18,100 18,394 15,876 13,934 16,367 12,670 18,616 23,440



Under 20 emergency respiratory admission rate 2015/16 420.0 460.0 397.3 542.0 434.6 271.6 417.2 267.9 374.6 515.5

Under 15 emergency unintentional and

deliberate injuries admission rate2015/16 945 1,019 902 1,125 774 1,042 831 816 1,041 903

15-24 emergency unintentional and deliberate

injuries admission rate2015/16 1,419 1,632 1,291 1,862 1,149 1,881 1,250 993 1,357 1,501



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Aylesbury Vale CCG Chiltern CCG

Chiltern CCG Southern Locality Profile...Centre, Southmead Surgery, The Misbourne Practice, Denham...

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Transcript of Chiltern CCG Southern Locality Profile...Centre, Southmead Surgery, The Misbourne Practice, Denham...